Treatment of Atrial and Ventricular Arrhythmias Through Autonomic Modulation

JACC. Clinical Electrophysiology
Sébastien P J KrulJoris R de Groot

Abstract

This paper reviews the contribution of autonomic nervous system (ANS) modulation in the treatment of arrhythmias. Both the atria and ventricles are innervated by an extensive network of nerve fibers of parasympathetic and sympathetic origin. Both the parasympathetic and sympathetic nervous system exert arrhythmogenic electrophysiological effects on atrial and pulmonary vein myocardium, while in the ventricle the sympathetic nervous system plays a more dominant role in arrhythmogenesis. Identification of ANS activity is possible with nuclear imaging. This technique may provide further insight in mechanisms and treatment targets. Additionally, the myocardial effects of the intrinsic ANS can be identified through stimulation of the ganglionic plexuses. These can be ablated for the treatment of atrial fibrillation. New (non-) invasive treatment options targeting the extrinsic cardiac ANS, such as low-level tragus stimulation and renal denervation, provide interesting future treatment possibilities both for atrial fibrillation and ventricular arrhythmias. However, the first randomized trials have yet to be performed. Future clinical studies on modifying the ANS may not only improve the outcome of ablation therapy but may also advanc...Continue Reading

References

Sep 1, 1972·British Heart Journal·R M NorrisS E Yeates
Oct 14, 1971·The New England Journal of Medicine·A J Moss, J McDonald
Oct 1, 1996·Journal of Cardiovascular Electrophysiology·P Coumel
Feb 1, 1997·The Anatomical Record·J A ArmourD A Hopkins
May 15, 1998·Journal of the American College of Cardiology·Z H SunL Toivonen
Sep 3, 1998·The New England Journal of Medicine·M HaïssaguerreJ Clémenty
Oct 12, 2000·Journal of the American College of Cardiology·D T KimM C Fishbein
May 28, 2002·Journal of Cardiovascular Electrophysiology·Jeffrey E OlginDouglas P Zipes
Mar 20, 2003·Heart and Vessels·Hiroaki KawanoKatsusuke Yano
Mar 12, 2004·Journal of the American College of Cardiology·Oleg F SharifovLeonid V Rosenshtraukh
Mar 27, 2004·Physiological Reviews·André G Kléber, Yoram Rudy
May 29, 2004·Circulation Research·Shengmei ZhouPeng-Sheng Chen
Apr 21, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Philippe ChevalierLaurent Fanton
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Amit S Dhamoon, José Jalife
Jun 1, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Eugene PattersonRalph Lazzara
Jun 7, 2005·Journal of the American College of Cardiology·Benjamin J ScherlagWarren M Jackman
Sep 3, 2005·The Journal of Clinical Investigation·Michael Rubart, Douglas P Zipes
Mar 29, 2006·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Robert LemeryMichael Gollob
May 30, 2006·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Seil OhTodor N Mazgalev
Aug 23, 2006·Pacing and Clinical Electrophysiology : PACE·Paul A GouldDavid M Kaye
Jan 3, 2007·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Yinglong HouSunny S Po
Jun 5, 2007·American Journal of Physiology. Heart and Circulatory Physiology·Joseph S UlphaniAlan H Kadish

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Citations

May 11, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Edmond M CroninUNKNOWN ESC Scientific Document Group
Oct 27, 2017·The Journal of Veterinary Medical Science·Nuttika PastarapateeChollada Buranakarl
Aug 5, 2020·Marine Drugs·David SergeevichevAlexander Chernyavskiy
Aug 12, 2020·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·L BoersmaJ R de Groot
Jan 28, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Edmond M CroninKatja Zeppenfeld
Sep 26, 2019·Frontiers in Physiology·Jason D BayerJoris R de Groot
Jun 15, 2019·Nature Reviews. Cardiology·Neil HerringDavid J Paterson
Dec 23, 2020·Neuromodulation : Journal of the International Neuromodulation Society·Yu WangPeijing Rong

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